Saint Vincent Delays Cerner EHR Implementation Due to Staffing Strike

Saint Vincent Hospital in Worcester, Mass., will delay the rollout of its new Cerner EHR implementation until early 2022 due to the ongoing staffing strike, according to the Worcester Business Journal.

In a memo circulated to staff on June 23, Carolyn Jackson, the hospital's chief executive officer, announced that the Cerner EHR implementation would be pushed off in order to ensure hospital wide training and adoption of the health IT.

“Despite having 200 Saint Vincent Hospital employed nurses now caring for patients, we cannot move forward with the go-live when there is no end in sight for the strike,” Jackson wrote. “Necessary build and training activities would be challenging to conduct under the current circumstances, and we want to ensure that both PBAR and Cerner launch successfully.”

Saint Vincent nurses have been on strike since March 8 over patient safety concerns surrounding nurse-patient staffing ratios.

Earlier this week, striking nurses denied a third proposal from the hospital. The Massachusetts Nurses Association (MNA) called the hospital’s most recent offer “the worst proposal made by the hospital since the strike began.”

Striking nurses submitted a counteroffer on Tuesday.

In the past year, Saint. Vincent nurses have filed over 600 official "unsafe staffing" reports in which nurses informed management that patient care conditions threatened patient safety. The nurses also report that the Worcester hospital has experienced an uptick in patient falls, preventable bed sores, and potentially dangerous delays in necessary treatment due to a lack of appropriate staffing.

Specifically, the nurses’ proposed staffing changes include limits on the number of patients nurses are assigned on many units, and a commitment to provide support staff positions across all units.

The nurses are also calling for the creation of a pool of nurses who are experts in caring for critically ill patients. This group of nurses would provide support for ED nurses who must take care of five or six patients while also caring for patients in need of ICU level care who are waiting for a bed to open in the ICU. The safe standard of care for ICU and trauma patients is one nurse per one to two patients, MNA said.  

Additionally, the nurses on strike are requesting "STAT and Rapid Response" nurses, who would be available to respond to critical situations when a patient is suffering a decline in her condition on medical/surgical floors.

These nurses assist in stabilizing and caring for patients until they can be transferred to the ICU, and they are especially necessary to support newly graduated nurses who most often work on shifts where there are fewer experienced nurses on staff.

A recent KLAS Impact Report found that the leading EHR satisfaction indicator among nurses was organization and health IT delivery.

“Part of the reason for this factor’s high impact is likely the role of nurse leadership—when these leaders effectively address frontline nurses’ EHR needs, perceptions of the EHR’s value are much higher,” KLAS explained.

“KLAS has found high variation in nurse EHR satisfaction (even among nurses using the same EHR), suggesting that with the right approach, it is possible for organizations to use their own resources to improve nurse EHR satisfaction without having to implement a whole new system,” the report authors noted.

Nurse respondents also reported EHR training, system response time, and end-user mastery as other key EHR success variables.

“The EHR is stable and reliable,” wrote a satisfied hospitalist respondent. “We used to have a lot of unexpected downtime, and that was untenable. I would appreciate having more options within the patient summary tabs to follow certain categories of conditions.”

On the other hand, some respondents were dissatisfied with the EHR.

“When it comes to functionality and how easy it is to learn, the EHR is a highly unintuitive system. . . . Integration is nonexistent, downtime is frequent, and safety seems to be the lowest priority, if it is a priority at all,” the dissatisfied hospitalist added.